Mood and Bipolar DOs Lecture Flashcards
Mixed Mania
Rapid Cycling
Bipolar II
Secondary Mania
Subtypes of bipolar DO
Simultaneous mania and depression
>40% prevalence of episodes
what subtype of bipolar?
Mixed mania
>4 episodes a year, what subtype of bipolar?
Rapid cycling
Hypomania (<4 days duration) alternating with depression
..what subtype of bipolar?
Bipolar II
Caused by drugs, tumor, CVA, SLE, endocrine, infections, huntington’s, wilson’s
what subtype of bipolar
Secondary mania
Genetic!
Risk of illness in a first degree relative is 10x the gen pop risk
Bipolar
Decreased inferior prefrontal cortex gray volumes
Decreased cerebellar vermis
Increased amygdala volume
Increased ventricular volume
Structural brain changes seen in bipolar DO
True or False:
The average patient with bipolar disorder does not receive a proper diagnosis for nearly a decade after the onset of his or her first episode
True
True or False…
Pts with cardiovascular disease are more likely to be depressed
true
Depression rates are highest in what type of women?
Early or late perimenopausal
Those using hormone therapy
Anxiety.
Sleep.
Sexual behavior.
Rhythms (Suprachiasmatic nucleus).
Temperature regulation.
CSF production.
which NT?
Serotonin
Mood
Cognition
Motor function
Drive
Aggression
Motivation
what NT?
Dopamine
Mood: – higher functions performed by the cortex.
Cognitive function: – function of cortex.
Drive and motivation: – function of brainstem
Memory and emotion: – function of the hippocampus and amygdala.
Endocrine response: – function of hypothalamus.
what NT?
Norepinepherine
Major Depression w/ or w/o psychotic features
Bipolar disorder - manic or depressed phase
Acute or Catatonic Schizophrenia
Some studies have shown efficacy in treating OCD, Delirium, NMS, Chronic pain syndromes, and intractable seizure disorders
..all indications for what type of therapy?
Electroconvulsive therapy
Relative Contraindications:
Recent MI,
Berry Aneurysm,
Brain Mass,
Increased Intracranial Pressure
Electroconvulsive therapy (ECT)
Ideation
Plans
Means
Intent
History
..all examined during which screening?
Suicide Risk Screening
Subtypes:
Seasonal affective disorder
Melancholia
Atypical depression
Catatonic depression
Major depressive disorder (MDD)
Tx= light therapy, bupropion, and SSRIs have been successful
Seasonal affective disorder
Characterized by anhedonia, psychomotor retardation or agitation, anorexia, weight loss, depressed mood (especially in the AM), feelings of guilt, sleep disturbance
Melancholia
This type of depression is characterized by overeating and weight gain, oversleeping, reactive mood, leaden paralysis and oversensitivity to interpersonal rejection
Atypical rejection
This type of therapy is effective in all types of major depressive disorders (MDD), but is usuaslly reserved for severly depressed patients or patients who are unresponsive or intolerant of psych meds
Electroconvulsive therapy (ECT)
____ can safely be used in pregnant and elderly patients, produces a rapid response, and has very few relative contraindications
ECT
Cognitive, interpersonal and behavioral therapy are effective, especially in combinaton with pharmacotherapy for….
Mood disorders
Which type of bipolar..
Characterized by occurrece of one or more manic or mixed episodes, which often cycle with depressive episodes, but the latter is not required for diagnosis
known as manic depression
Bipolar I
Which type of bipolar…
Characterized by at least one or more major depressive episodes and at least one hypomanic episode
This pt has never experienced a manic episode or a mixed episode
Bipolar II
